travel health

What I learnt trekking Nepal (with a two year old strapped to my back) - Dr Tania Nishimura

Around eight years ago, I had the idea that we trek the Ghorepani Ghandruk circuit in Nepal with our boys, two and four years old.

Some (most) said I was mad. Luckily my adventurous husband wasn’t one of them.

When the time came to leave, I felt confident my family was in good hands. My knowledge of travel medicine, my experience gained through many overseas trips, and some good ol’ fashioned planning held us in good stead.

So, allow me to share some tips with you.

Here’s my overseas travel health advice presented in two simple categories: before and during your trip. Taken into account, your after will spent reminiscing about the fun times had for years to come.

Before: what to consider prior to travel

You can never be 100% prepared for all scenarios, but you can certainly try.

Consider your state of health for the destination

We were all fit and healthy before leaving for Nepal, though our youngest did have asthma. He got to spend most of his time being carried – lucky bugger.

We also chose the less strenuous route from a few options we had. A great idea in hindsight, especially considering how exhausting it was!

Top tip:  Forget the physically active trips if you have a history of heart problems, a recent serious illness or if you struggle to climb a flight of stairs – it’s just not worth it. What a great excuse to laze by the pool in some fancy resort, eh?

Pack your regular medications

I put together a practical medical travel kit that covered all the basics, including the obvious asthma puffers and medication for asthma flares.

For the kids, it also contained antihistamines for allergies, paracetamol or ibuprofen for fever and aches, 1% hydrocortisone cream for insect bites and rashes, oral re-hydration packets, and a thermometer. We also found it handy to have some baby wipes for cleaning on the go.

For my husband and I, we packed for common travellers’ problems, such as anti-diarrhoeal medication, general antibiotics, simple dressings and bandages, 50+ sunscreen, DEET strength insect repellent, and anti-motion sickness medication.

I’m sure we forgot something…

Top tips:  Visit your GP for help preparing a medical travel kit suited to your destination. Avoid buying medication overseas as these can be fake or falsely labelled. If you’re on the contraceptive pill, be conscious that some factors might make it less effective when travelling, such as gastroenteritis and other antibiotics. Different time zones can make it easy to forget a dose.

Get travel insurance

Don’t step foot out of Australia without travel insurance.

Travelling overseas without insurance is a recipe for disaster – just ask the thousands of uninsured ‘indestructible’ teens who have come off their scooters in Kuta, now in debt or literally scarred for life.

According to the Department of Foreign Affairs and Trade (DFAT), daily hospital costs in Southeast Asia often surpass $800. DFAT also regularly coordinate medical evacuations from Bali which exceed $60,000. Yikes!

Manageable accidents in Australia may be difficult to treat in other countries where hospital quality and doctor training lacks. Many travellers have died overseas during simple procedures, largely due to secondary infections.

Top tips:  Check if your travel insurer covers pre-existing conditions. Also, be aware that most insurers won’t cover scooter-related accidents unless you have a valid Australian motorcycle licence.

Visit your GP

Even being a doctor myself, albeit a bit less experienced than I am now, I took my family to our GP before leaving.

We received all the proper vaccines for Nepal, including for hepatitis A, typhoid and rabies. The latter was especially important for us as children are at higher risk of being bitten by animals, making them more likely to be exposed to the virus.

Luckily we didn’t need anti-malarial medications as there are none suitable for children as young as ours.

Top tips:  See your GP early as some vaccines need to be given up to two months before you travel. And don’t forget to bring along your itinerary – any good GP can advise on the right precautions for each destination.

During: what to look out for at your destination

Another important lesson I learnt travelling, with or without kids, is to expect the unexpected. Crazy things can and will happen when. Here are a few things to look out for.

Road safety

There were some rather questionable forms of transport and dubious road conditions in Nepal. We played it safe and erred on the side of caution – even if it did take us a bit longer to get from A to B.

However, road accidents are one of the biggest causes of injury and fatalities for Australian travellers. Local laws can be quite lax as far seatbelts, helmets, and road rules are concerned.

Top tips:  Don’t always choose the quickest and cheapest form of transport. Take your sweet time and be open to some amazing cultural experiences. Oh, and give the scooters a wide berth.

Personal safety

The first thing we did at each new lodging was promptly kid-proof the room. You can’t get too paranoid, or you’ll drive yourself insane. We’d just check for dodgy power points, unsafe window openings, balcony access, and door locks.

People tend to let their guard down when holidaying overseas. While this is the way it should be, it’s a good idea to keep check of your surroundings. Taking risks you wouldn’t at home, trusting ‘super-friendly’ locals, and hitting the booze too hard can get you into sticky situations.

Top tip:  Always practise safe sex. The prevalence of STI’s and HIV is much higher in different countries. Have fun, use protection.

Food and water safety

The tap water is unsuitable for drinking in most developing countries, including Nepal. Even though we saw many locals drinking the water, we avoided it like the plague. Diarrhoea, giardia, typhoid, and cholera weren’t welcome travel companions.

Food quality and preparation also needs a mention. The World Health Organisation recommends food precautions when travelling overseas, including washing your hands regularly, avoiding uncooked food, cooking food thoroughly, and holding food temperatures below 5°C and above 60°C.

Top tip:  Keep in mind that the local tap water will likely be used to wash vegetables and make ice.

Animal and mosquito safety

Children love animals and are as curious as the beasts themselves, but extreme caution should be taken to avoid contact. That temple-dwelling monkey is only a cute little fur ball until it bites your kid and you’re off to the local hospital for the rest of the day.

Malaria, zika virus, dengue fever, yellow fever, Japanese encephalitis, and chikungunya are all horrible diseases transmitted by mosquitoes. Vaccines and preventative medications only exist for malaria and Japanese encephalitis, yet complete protection is impossible.

Additional precautions against mosquito bites are a must. Use insect repellent, avoid still bodies of water, and sleep under nets. Don’t waste your money on mosquito repellent wristbands; they’ll only stop your wrist from getting bitten.

Top tip:  Use only DEET-based insect repellent when holidaying in tropical locales.

I hope I haven’t scared anyone from travelling to any of the wonderful far-flung destinations on offer – especially with kids in tow. Having the time of your life just takes a bit of planning and common-sense.

Of course, unforeseen things happen, but my philosophy is that they can happen anywhere. If you limit yourself because of the unknown, you’ll never leave the couch, right?

Enjoy your travels and make some great memories!

Dr Tania Nishimura is a senior GP at Doctors of South Melbourne. She has extensive experience in travel medicine and is a keen world traveller. You can book an appointment with Tania here.